June 3, 2020 Issue, Page 4 of 8

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Page 4 The Elk City News, Elk City, Oklahoma Wednesday, June 3, 2020 Point: Math behind Trump’s Opinion Page “ElkCituNews ‘Buy American’ supply chain Serving Western Oklahoma since 1901 International policy doesn’t add up medical school By Peter J. Pitts, Inside- the United States.” 13% are in China and an ad- shortages. Again, only 28% graduates can help Sources.com Not quite. ditional 18% are in India. of APIs are made here in the Well-meaning but con- First, consider the source Meanwhile, 28% of API United States. Bringing that fused protectionists have of that statistic. As Eric facilities are in the United figure to 100% would mean fight COVID-19 bent President Trump’s ear on trade policy, Donald Boehm noted in Reason, most mentions of the num- States. The report goes on to note building up manufacturing capacity at an unprecedented spinning the narrative that ber in the mainstream press that, among the 370 drugs on By Richard Liebowitz, MD, MHSc the U.S. biopharmaceutical point back to an August press the World Health Organiza- rate. industry is overly dependent release from Senate Foreign tion’s essential medicines An undertaking of such COVID-19 has disproportionately impacted low-income on Chinese manufacturers Relations Committee Chair list, only three contain APIs magnitude would face all and minority communities across the United States. In for raw materials. Chuck Grassley, R-Iowa. sourced entirely from China. manner of regulatory and New York City, the epicenter of the pandemic, the poor- They're pressing him to But Grassley doesn’t claim Add it all up, and one financial hurdles. Accord- implement a “Buy Ameri- that 80% of American drugs thing is clear: the claim that est quarter of zip codes account for 36 percent of corona- can” policy _ during the come from China, just that 80% of America’s drugs ing to a recent study by the virus cases. The wealthiest quarter, by contrast, account worst pandemic in more “80% of Active Pharmaceu- come from China doesn’t Pacific Research Institute, for less than 10 percent. African-Americans and Latinos than 100 years _ for all bi- tical Ingredients (API) are hold. The best data doesn’t relocating just a single drug are more likely to call these hardest-hit zip codes home. opharmaceuticals, —_ active produced abroad, the major- come close to suggesting manufacturing facility can pharmaceutical ingredients ity in China and India.” that America is particularly This phenomenon isn’t unique to New York City. In and medical equipment. Dig a little deeper, and the cost $2 billion over the dependent on China for our course of a decade. During Illinois, African-Americans comprise 15 percent of the This push to national- original statistic looks even pharmaceuticals. Our medi- population but 30 percent of confirmed coronavirus cas- ize the biopharmaceutical more spurious. Grassley’s cines originate from a di- this time, supplies of many es. In Michigan, they represent 14 percent of the popu- supply chain is rooted in a figure comes from a 2016 verse global supply chain drugs would drop to zero. single statistic that purports Government Accountability that includes more than 150 Amid a_ global health lation, but 30 percent of cases and 40 percent of deaths. 80% of America’s drug sup- Office study. Yet that report countries. emergency like COVID-19, Of course, the virus isn’t deliberately targeting minor- ply comes from China. only states that “80% of ac- But this hasn’t stopped the such massive supply chain ity neighborhoods. But minorities often live in higher den- But that figure is based tive pharmaceutical ingre- Trump administration from disruptions would prove cat- sity housing and suffer from chronic conditions at higher on a fundamental misread- dients are manufactured in moving ahead with its “Buy ing of a government report. registered establishments in American” policy. Accord- astrophic. rates than white Americans. And COVID-19 is particu- And this distortion of the more than 150 countries.” ing to White House adviser “Buy American” advo- larly deadly for anyone with underlying health conditions. truth is spurring the Trump And even that figure is far Peter Navarro, an executive cates base their arguments To combat this pandemic -- and the next one -- we'll administration to advance from rock solid. That’s be- order requiring federal agen- on inflated statistics about a trade protectionist policy cause the GAO report mis- cies to source medical goods dangers that simply don’t need to do more to fight chronic disease. That starts by im- that would put American used data from the FDA. By exclusively from domestic exist. The biggest threat to proving access to primary care in at-risk neighborhoods, lives at serious risk for years the FDA’s own admission, it manufacturers could be im- America’s supply of medi- which suffer from severe shortages of medical personnel. to come. doesn’t monitor “what por- minent. As he put it in an in- The assertion that 80% tion of U.S. drug consump- terview in early May, “Buy cines isn’t foreign manufac- Graduates of international medical schools have long been of America’s drugs come tion is dependent on APIs American’ is going to be the turers, but policies that put the physicians to fill these gaps. And many of these phy- from China is often used to from China or India, or an- law of the land, I believe, protectionist ideology before sicians aren’t foreign at all -- they’re U.S. citizens who inspire fear about access to other country.” soon at HHS, DOD, the Vet- basic facts and human life. chose to attend medical school abroad. Our leaders must needed medicines during the The FDA does have some erans administration.” Peter J. Pitts, a former welcome and train more of them in the United States. COVID-19 crisis. As Rep. data on API manufacturing That reform won’t make FDA associate commission- Chip Roy, R-Texas, recently facilities around the world. America’s health care sys- The United States already faces a shortage of er, is president of the Center explained, “If the Chinese And according to a recent tem more resilient. In fact, it up to 43,000 physicians. That figure may increase wanted to put us in a serious report that examined the fa- would almost certainly lead for Medicine in the Public to 122,000 -- including 55,000 primary care doc- bind, they could withhold cilities that supply APIs for to severe price hikes and Interest. He wrote this for tors -- by 2032. These shortages are particularly se- these lifesaving drugs from drugs sold in America, only widespread pharmaceutical InsideSources.com. vere in low-income and minority neighborhoods. International medical graduates (IMGs) are well-posi- tioned to address these shortages. They’re already more Counterpoint: A critical supply likely than their U. chain America must bring home .-educated peers to practice in low- income areas. About 25 percent of all doctors in the Unit- ed States attended medical school outside the country. But in neighborhoods where per-capita income is below $15,000 per year, IMGs account for 43 percent of doctors. By Paul Steidler, Inside- ecutive order to protect the and safety.” tion. There are also signifi- Sources.com bulk-power system. This Moody’s, the credit rating cant opportunities to sell IMGs are also likely to serve in disciplines experienc- In recent weeks Ameri- is the critical energy infra- agency, endorsed the execu- power grid items abroad. ing the most acute doctor shortages. In 2019, nearly cans have been aghast and structure that supports na- tive order in a May 6 report Today there is an aggres- 70 percent of international medical graduates went disgusted to see the danger- tional defense, emergency saying it is “a credit positive sive push to make the grid into primary care --- including specialties like in- ous extent to which we rely services, critical infrastruc- for U.S. electric utilities be- smarter, using software and ternal medicine, family medicine, and pediatrics. on China for the personal ture and the economy, those cause it addresses some of technology to handle func- International medical graduates are already on the frontlines protective equipment so vi- things that ensure the quality the cybersecurity risks that tions like equipment moni- tal to health care workers. of modern life. relate to the supply chain. fighting COVID- 19. Morethan750 graduates of St. George’s Compounding this, we are Even though the bulk- The executive order also toring so that components can be replaced before they University, the medical school I lead, have begun residencies also dependent on China for power system is integral to raises corporate governance in New York City over the past four years. The vast major- other critical medical sup- our well-being, large compo- break. Many consumers also priorities around cybersecu- ity of them are U.S. citizens who returned home to practice. plies, including pharmaceu- nents of it, including control rity defenses and promotes want to adjust their electric- ticals. systems, transformers and needed investments in cy- ity use remotely. These and In some parts of the Bronx, nearly 80 percent of doctors other factors show the need Unfortunately, — medical generators are increasingly bersecurity preparedness.” are international medical graduates. Almost four of every items are not the only life- being manufactured over- The crux of the order for infrastructure invest- ten doctors in New York are IMGs. They also make up threatening supply chain seas. Especially disturbing is to require a rigorous re- ments while significantly nearly 40 percent ofthe physician workforce in New Jersey. vulnerability we have. that 200 transformers, a pil- view of suppliers and the reducing the likelihood that But given the depth of the doctor shortage, we need The U.S. electric system lar of the power grid, have development of a prequali- the software will be hacked more. Congress can combat these physician shortages has become increasingly de- come from China into the fied vendor list. In addition, by an adversary or embed- by enacting the Resident Physician Shortage Reduction pendent on foreign suppliers United States in the last 10 now prohibited equipment ded for future mischief. years, according to Charles already in use is to be iden- for essential items, including The executive order, Act, which would increase the number of residencies software components that Durant, deputy director of tified, isolated, monitored though, is a beginning and funded by Medicare by 15,000 between 2021 and 2025. can easily be cyberattacked. counterintelligence at the and, if necessary, replaced. not an end in protecting COVID-19 has been so destructive in part because mil- When the hardware or soft- Department of Energy. Be- This will also provide a America’s electric grid. lions of Americans struggle with chronic conditions that ware of the electric grid fore then, none had entered stimulus for the U.S. econ- Rules are to be issued in Sep- have left them susceptible to the coronavirus’s ravages. malfunctions or is attacked, the United States. omy. tember. The administrative there are power outages and The executive order says, According to the Depart- Our healthcare system must do a better job treating and often related chaos. “The bulk-power system ment of Energy, the United and political follow-through preventing chronic disease in vulnerable populations. The good news is that the is a target of those seeking States spends $144 billion will remain important for years ahead and should be Primary care physicians can do that job. And there’s no United States has taken clear to commit malicious acts annually on electricity gen- better source of primary care physicians than international and compelling steps to ad- against the United States eration, transmission and supported across the politi- dress these security vulner- and its people, including distribution infrastructure. cal spectrum. medical schools. It’s time to bring more of their graduates in. abilities, though years of malicious cyber activities, This may rise significantly. Paul Steidler is a senior Dr. Richard Liebowitz is vice chancellor of St. George's follow-through are also nec- because a successful attack Much of the power grid, in- fellow with the Lexington University (www.sgu.edu). Previously, he was president of essary. on our bulk-power system cluding plants and transmis- Institute, a think tank in Ar- New York-Presbyterian Brooklyn Methodist Hospital. This On May 1, President Don- present significant risks to sion lines, is decades older lington, Va. He wrote this piece originally ran in the International Business Times. ald Trump signed an ex- our economy, human health and in need of moderniza- for InsideSources.com. Have something to share? Send your editorial to [email protected]